TY - JOUR
T1 - Epithelial Dysplasia and Cancer in IBD Strictures
AU - Sonnenberg, Amnon
AU - Genta, Robert M.
N1 - Publisher Copyright:
Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation (ECCO) 2015. This work is written by US Government employee and is in the public domain in the US.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - BACKGROUND: Colonic strictures and epithelial dysplasia are both known risk factors for the occurrence of colorectal cancer in inflammatory bowel disease (IBD) patients. The aim of the present work was to study colonic stricture as a risk factor for the occurrence of epithelial dysplasia and colonic adenocarcinoma.METHODS: In a case-control study among 53568 IBD patients undergoing colonoscopy, we compared the prevalence of strictures among cases with dysplasia or adenocarcinoma and controls without such complications by calculating odds ratios (ORs) and their 95% confidence intervals (CIs). Multivariate logistic regressions were used to assess the joint influence of multiple predictor variables (age, sex, IBD type and stricture) on the occurrence of colonic dysplasia or adenocarcinoma.RESULTS: The prevalence of strictures was 1.06% in ulcerative colitis (UC) and 8.71% in Crohn's disease (CD, OR 11.09, 95% CI 9.72-12.70). The prevalence of dysplasia was 3.22% in UC and 2.08% in CD (OR 0.75, 95% CI 0.65-0.86). The prevalence of dysplasia was similar in IBD patients with and without stricture: 2.82 and 2.41%, respectively. The prevalence of cancer was higher in IBD patients with than without stricture: 0.78 and 0.11%, respectively (OR 6.87, 95% CI 3.30-12.89). In the multivariate analysis, old age, male sex and UC, but not stricture, were all significantly and independently associated with dysplasia. Old age, dysplasia and stricture were significantly and independently associated with cancer.CONCLUSION: The prevalence of epithelial dysplasia is not generally increased in IBD patients with strictures.
AB - BACKGROUND: Colonic strictures and epithelial dysplasia are both known risk factors for the occurrence of colorectal cancer in inflammatory bowel disease (IBD) patients. The aim of the present work was to study colonic stricture as a risk factor for the occurrence of epithelial dysplasia and colonic adenocarcinoma.METHODS: In a case-control study among 53568 IBD patients undergoing colonoscopy, we compared the prevalence of strictures among cases with dysplasia or adenocarcinoma and controls without such complications by calculating odds ratios (ORs) and their 95% confidence intervals (CIs). Multivariate logistic regressions were used to assess the joint influence of multiple predictor variables (age, sex, IBD type and stricture) on the occurrence of colonic dysplasia or adenocarcinoma.RESULTS: The prevalence of strictures was 1.06% in ulcerative colitis (UC) and 8.71% in Crohn's disease (CD, OR 11.09, 95% CI 9.72-12.70). The prevalence of dysplasia was 3.22% in UC and 2.08% in CD (OR 0.75, 95% CI 0.65-0.86). The prevalence of dysplasia was similar in IBD patients with and without stricture: 2.82 and 2.41%, respectively. The prevalence of cancer was higher in IBD patients with than without stricture: 0.78 and 0.11%, respectively (OR 6.87, 95% CI 3.30-12.89). In the multivariate analysis, old age, male sex and UC, but not stricture, were all significantly and independently associated with dysplasia. Old age, dysplasia and stricture were significantly and independently associated with cancer.CONCLUSION: The prevalence of epithelial dysplasia is not generally increased in IBD patients with strictures.
KW - Colon cancer
KW - dysplasia
KW - epidemiology
KW - histopathology of inflammatory bowel disease
KW - intestinal strictures
UR - http://www.scopus.com/inward/record.url?scp=84973487066&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84973487066&partnerID=8YFLogxK
U2 - 10.1093/ecco-jcc/jjv108
DO - 10.1093/ecco-jcc/jjv108
M3 - Article
C2 - 26079724
AN - SCOPUS:84973487066
SN - 1873-9946
VL - 9
SP - 769
EP - 775
JO - Journal of Crohn's & colitis
JF - Journal of Crohn's & colitis
IS - 9
ER -